Understanding fatigue in adults with visual impairment: A path analysis study of sociodemographic, psychological and health-related factors.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
14
06
2019
accepted:
10
10
2019
entrez:
26
10
2019
pubmed:
28
10
2019
medline:
14
3
2020
Statut:
epublish
Résumé
Fatigue is a disabling problem in patients with visual impairment, but its etiology is still poorly understood. Our objective was to identify the determinants of fatigue in adults with visual impairment compared to adults with normal sight. Cross-sectional data on fatigue and sociodemographic, psychological and health-related factors was obtained with validated questionnaires. Structural equational modeling using hypothesized relationships and explorative analyses were used to identify (in)direct pathways contributing to fatigue in 247 adults with visual impairment. The model was then tested in a reference group of 151 adults with normal sight. The final model explained 64% of fatigue variance in participants with visual impairment and revealed the following factors to be directly associated with fatigue: depressive symptoms (β = 0.723, p<0.001), perceived health (β = -0.158, p = 0.004), accommodative coping (β = 0.116, p = 0.030) and somatic comorbidity (β = 0.311, p = 0.001). Self-efficacy demonstrated a beneficial indirect effect on fatigue (β = -0.228, p<0.001) mediated by depression, accommodative coping and perceived health. Sleep disorder had an indirect effect on fatigue (β = 0.656, p<0.001) mediated by depression and perceived health. After removal of sleep disorder, the model explained 58% of the fatigue variance in normally sighted adults but pathways involving accommodative coping and somatic comorbidity were not confirmed. These findings suggest that depression and perceived health are important mediating factors that contribute to fatigue in persons with visual impairment and normal sight. In contrast, somatic comorbidity, sleep disorders and accommodative coping seem to have a specific contribution to vision-related fatigue. These factors should be addressed in interventions to assist individuals with visual impairment in dealing with fatigue.
Sections du résumé
BACKGROUND
Fatigue is a disabling problem in patients with visual impairment, but its etiology is still poorly understood. Our objective was to identify the determinants of fatigue in adults with visual impairment compared to adults with normal sight.
METHODS
Cross-sectional data on fatigue and sociodemographic, psychological and health-related factors was obtained with validated questionnaires. Structural equational modeling using hypothesized relationships and explorative analyses were used to identify (in)direct pathways contributing to fatigue in 247 adults with visual impairment. The model was then tested in a reference group of 151 adults with normal sight.
RESULTS
The final model explained 64% of fatigue variance in participants with visual impairment and revealed the following factors to be directly associated with fatigue: depressive symptoms (β = 0.723, p<0.001), perceived health (β = -0.158, p = 0.004), accommodative coping (β = 0.116, p = 0.030) and somatic comorbidity (β = 0.311, p = 0.001). Self-efficacy demonstrated a beneficial indirect effect on fatigue (β = -0.228, p<0.001) mediated by depression, accommodative coping and perceived health. Sleep disorder had an indirect effect on fatigue (β = 0.656, p<0.001) mediated by depression and perceived health. After removal of sleep disorder, the model explained 58% of the fatigue variance in normally sighted adults but pathways involving accommodative coping and somatic comorbidity were not confirmed.
CONCLUSIONS
These findings suggest that depression and perceived health are important mediating factors that contribute to fatigue in persons with visual impairment and normal sight. In contrast, somatic comorbidity, sleep disorders and accommodative coping seem to have a specific contribution to vision-related fatigue. These factors should be addressed in interventions to assist individuals with visual impairment in dealing with fatigue.
Identifiants
pubmed: 31652298
doi: 10.1371/journal.pone.0224340
pii: PONE-D-19-16894
pmc: PMC6814229
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0224340Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Rheumatol. 2012 Sep;39(9):1807-13
pubmed: 22660801
Invest Ophthalmol Vis Sci. 2010 Jun;51(6):2891-6
pubmed: 20164466
Psychol Med. 2017 Jul;47(10):1733-1743
pubmed: 28193310
Nat Rev Clin Oncol. 2014 Oct;11(10):597-609
pubmed: 25113839
Psychol Bull. 1990 Mar;107(2):238-46
pubmed: 2320703
Neurorehabil Neural Repair. 2008 Jan-Feb;22(1):91-100
pubmed: 17409388
Disabil Rehabil. 2011;33(1):63-72
pubmed: 20518624
Aging Ment Health. 2014 Jul;18(5):662-70
pubmed: 24479829
BMJ. 2015 Nov 23;351:h6127
pubmed: 26597263
Invest Ophthalmol Vis Sci. 2015 Jan 20;56(2):849-54
pubmed: 25604690
Oncotarget. 2017 May 30;8(22):36800-36811
pubmed: 28404938
Ophthalmic Epidemiol. 2007 May-Jun;14(3):119-26
pubmed: 17613846
Rehabil Psychol. 2012 Nov;57(4):320-7
pubmed: 23181581
Psychol Methods. 2007 Mar;12(1):23-44
pubmed: 17402810
Cancer. 2017 Oct 1;123(19):3825-3834
pubmed: 28621820
Psychosom Med. 2010 Jan;72(1):88-96
pubmed: 19949160
J Clin Sleep Med. 2016 Feb;12(2):235-45
pubmed: 26350604
PLoS One. 2015 Feb 18;10(2):e0115541
pubmed: 25692993
BMJ Open. 2018 Jan 23;8(1):e016297
pubmed: 29362245
PLoS One. 2018 Jun 22;13(6):e0198588
pubmed: 29933367
JAMA. 1989 Sep 15;262(11):1479-84
pubmed: 2769898
JAMA Intern Med. 2015 Sep;175(9):1461-72
pubmed: 26147487
Depress Anxiety. 2018 Aug;35(8):717-731
pubmed: 29782076
Invest Ophthalmol Vis Sci. 2001 Jan;42(1):64-72
pubmed: 11133849
BMJ Open. 2017 Aug 3;7(8):e015023
pubmed: 28775181
Curr Opin Rheumatol. 2017 May;29(3):269-276
pubmed: 28207494
Ophthalmic Physiol Opt. 2016 Sep;36(5):584-606
pubmed: 27580757
Autoimmun Rev. 2016 Mar;15(3):210-20
pubmed: 26589194
J Affect Disord. 2011 Dec;135(1-3):10-9
pubmed: 21300408
Med Care. 2002 Sep;40(9):771-81
pubmed: 12218768
Arthritis Care Res (Hoboken). 2013 Jul;65(7):1128-46
pubmed: 23335492
Health Psychol. 2018 Jun;37(6):530-543
pubmed: 29781654
Invest Ophthalmol Vis Sci. 2004 Jan;45(1):71-6
pubmed: 14691156
Invest Ophthalmol Vis Sci. 2018 Apr 1;59(5):1916-1923
pubmed: 29677352
Cancer Nurs. 2009 Sep-Oct;32(5):398-403
pubmed: 19661795
Can J Neurol Sci. 1994 Feb;21(1):9-14
pubmed: 8180914
J Sleep Res. 2013 Feb;22(1):104-7
pubmed: 22924964
Ophthalmologica. 2008;222(3):205-12
pubmed: 18497531
Sleep. 2008 Oct;31(10):1351-6
pubmed: 18853932
J Behav Med. 2010 Oct;33(5):355-63
pubmed: 20508981
Oncol Nurs Forum. 2016 Nov 1;43(6):762-771
pubmed: 27768127
J Neurol Neurosurg Psychiatry. 2013 Oct;84(10):1092-9
pubmed: 23695501